Türkçe
ASSOCIATE PROFESSOR SABAHATTİN DESTEK | GENERAL SURGERY SPECIALIST
Pilonidal sinus disease is most common between the ages of 15-25 and 80% of patients are men. Approximately 1% of men are at risk of developing this disease at some point in their lives. It usually (95%) occurs in the coccyx area and develops as a result of inflammation of the hair follicles under the skin. The disease starts by forming a fistula-like opening in the coccyx. Over time, these canals proliferate and the entire skin in the coccyx can be affected. It is a progressive disease with intermittent abscess attacks and surgical intervention is usually inevitable in its treatment.
The main cause of ingrown hair is blockage and infection of the hair follicle canal. This condition is more common in people who work sitting for a long time, those who are overweight, those who have wounds or acne in the coccyx area, injuries caused by waxing or razor blades, excessively hairy individuals, those who frequently carry heavy loads and those with a family history of ingrown hair. Although ingrown hairs are mostly seen in the coccyx, they can also occur in other areas such as the armpits, neck and groin area.
Symptoms include stinging sensation, pain, swelling, redness and draining abscesses. In the case of a closed abscess, throbbing pain can occur and patients often present to the emergency room with these complaints. The pain may increase with activities such as sitting, walking or prolonged immobilization.
To reduce the risk of ingrown hairs, daily bathing/showering, as well as improving personal hygiene are useful in preventing the disease. It has been observed that laser hair removal on very hairy bodies reduces the likelihood of the disease developing or recurring after treatment by 20-40%.
Permanent treatment of ingrown hair is surgical.
In simple applications, crystallized phenol is applied into the ingrown hair to chemically irritate and treat the ingrown hair area. Early stage patients are selected. The procedure is normally harmless and can be performed daily without interrupting social activities and daily life. However, since the remnants of the ingrown hair remain, the chance of success is lower (75-80%) and the chance of recurrence is high (20%).
In classical surgical procedures, the ingrown ingrown hair in the coccyx can be extensively removed and the depression formed can be closed with primary closure or closure interventions such as Limberg, Karydakis or V-Y type flaps can be performed. In these methods, the hospitalization period is 1 day and the patient is asked to protect the wound site, restrict his/her work and not to sit until the sutures are removed in 2 weeks. The possibility of recurrence of the disease is around 5-20% with these techniques.
In the Micro Sinusectomy method, the sinus canals caused by ingrown hair are cleaned with a small surgical procedure. In this procedure performed under local anesthesia, the tissues under the skin that cause ingrown hairs are removed through a small incision. The procedure takes 10 minutes. It will be enough to apply a dressing instead of a small wound. The patient can return to work immediately after the procedure. The next shower can take a bath. The chance of recurrence is around 1-5%.